Weaning

Topic Overview

What is weaning?

Weaning is the term used to
describe the process of switching a baby from:

Breast-feeding to
bottle-feeding.

Breast- or bottle-feeding to a
cup.

Breast- or bottle-feeding to solid foods.

Your baby will go through one or more of these weaning
processes. All types of weaning usually work best when they are done
gradually—over several weeks, months, or even longer.

Weaning a
baby from the breast is a big change for moms as well as for babies. Besides
affecting you physically, it may also affect you emotionally.

Some moms feel a little sad to lose some of the closeness that
breast-feeding provides. But you will also have more freedom, because others
can feed your baby. Don't be surprised if you feel both happy and sad that your
child is becoming more independent.

How do you know if your baby is ready to wean?

Signs that a baby is ready to wean often appear after the baby has
learned to crawl or learned to walk. Your breast-feeding baby may suck a few
times and then stop nursing. He or she may just start to lose interest in your
breast.

Bottle-fed babies who are ready to wean may start spitting
out the nipple or throwing or hiding the bottle before it is empty. Your baby
may show more interest in drinking from a cup.

When is the best time to wean?

When to start weaning mostly depends on how ready you and your child are to start weaning.

Some breast-feeding moms aren't ready to give up the closeness
that breast-feeding brings. So they may delay weaning, even though their child is ready. Other moms are ready to wean sooner or have
responsibilities or life changes that make it necessary.

There is no right
or wrong time to start, and there's not a certain amount of time to take, except that it's best to wean your baby from a bottle by 18 months of age. Also, try not to start weaning when your child or your
family is under stress. Stress can range from cutting a new tooth to moving to
a new house or starting a new day care program.

What is the best way to wean a baby?

Gradual
weaning is best for both babies and moms. Look for signs that your baby is
ready. When you are both ready, try dropping one feeding every 5 to 7 days.
This will help give you and your baby time to adjust to new ways of feeding. If
you are breast-feeding, gradual weaning helps keep your breasts from becoming
too full, a problem called
breast engorgement.

Begin to introduce solid foods at 4 to 6 months of age to complement the breast milk or formula.

Do not feed your baby cow's milk before 12 months of age.

You can also give your baby breast milk from a cup or a
bottle.

What if your baby does not want to be weaned?

Sometimes a mother wants to stop breast-feeding but her baby seems to
want to keep it up. If you can, keep breast-feeding a while longer. Try
offering your milk or formula in a cup or bottle before you breast-feed or between
breast-feedings. There are also different bottle nipples you can try.

Some babies grow attached to the bottle and do not want to give it up.
Don't let your baby crawl, walk around, or go to bed with a bottle. Nighttime
feedings are often the hardest to give up. Try replacing that feeding with new
habits, such as reading a book or looking at the stars together.

What Is Expected

Weaning is
usually a gradual process. It starts when you begin feeding your baby in other
ways than breast- or bottle-feeding. And it ends when the child no longer
breast-feeds or takes a bottle. This process may last several weeks, a few
months, or more than a year.

Your baby may begin eating solid foods at 4 to
6 months of age. At this point, you may want to offer cup-feeding
to supplement breast- or bottle-feedings. Over the next 6 months, your baby may
show
signs that he or she is ready to wean .

It is important to switch gradually to the cup. Although
some mothers stop breast- or bottle-feedings abruptly, the baby may not be
ready. Babies find comfort from sucking and also may need the closeness and
comfort breast- or bottle-feeding provides. Always think about your baby's
emotional needs, age, and readiness as well as about your own needs, when
switching from breast- or bottle-feeding to a cup. Toddlers (ages 1 to 2) may
tolerate abrupt weaning better than babies.

Weaning from breast-feeding

Start by replacing one daily breast milk feeding with a bottle or cup of
formula . Pick your least favorite feeding. Every few days, replace an additional breast milk feeding until your baby is fed only with formula. (Use milk instead of formula if your baby is age 1 year or older.)

When you start to
wean your young baby from the breast, replace your breast
milk with enough iron-fortified infant formula to make up for fewer nursing
sessions. After your baby stops breast-feeding, give him or her at least
16 fl oz (500 mL) to
24 fl oz (750 mL) of formula
each day. When your baby is 4 to 6 months of age and older, give solid
foods high in
iron and vitamin C. Babies at least 12 months of age can also have cow's milk.

The following tips may help you wean:

After your baby is 4 months of age, try letting
him or her drink from a cup. If your baby is not ready, you can start weaning
by switching to a bottle.

Slowly reduce the number of times you
breast-feed each day. Replace a breast-feeding with a cup- or bottle-feeding
during one of your daily feeding times. Stay with that routine for a week. Then
the next week, choose an additional time of day to replace or shorten your
regular breast-feeding time. Each week, choose one more breast-feeding time
to replace or shorten.

Offer the cup or bottle before each
breast-feeding. Some babies may not accept a bottle or cup until they have
nursed.

If you breast-feed before bedtime or a nap, lay your baby
down before he or she is asleep. Help your baby learn to fall asleep without
the aid of breast-feeding. A new bedtime ritual can help.

Hold and
cuddle your baby to make up for the loss of skin contact during breast-feeding.
If a baby asks for more breast-feedings, make them up through touching and
holding.

Weaning from bottle-feeding

Your bottle-fed baby should continue to get nutrition
largely from formula until he or she is 12 months old. After that, allowing
your child to continue drinking from a bottle may lead to problems such as
baby bottle tooth decay.

These suggestions may be helpful when you are trying to get
your baby to stop taking a bottle.

Get rid of one bottle-feeding every 5 to 7 days.
Give your baby extra hugs and comfort during this change.

Give a
bottle only when your baby is being held in your arms. Do not allow your baby
to crawl, walk around, or go to bed with the bottle. Doing so turns the bottle
into a comfort item, may hinder two-handed development, and can lead to
dental cavities.

Offer the cup first, then
the bottle. Put a little more liquid in the cup and a little less liquid in the
bottle each time.

If your baby is 6 months of age or older, gradually dilute the formula in the bottle with water
so that it will not taste as good.

Put liquids your child
likes in the cup, and put liquids your child does not like as much in the
bottle. Later, put only water in the bottle, and put juice, iron-fortified
formula, or milk (if the baby is over 1 year old) in the cup.

Start a new bedtime ritual. Read a story and then give the bottle
while you rock your baby. At each bedtime, slowly decrease the time your child
drinks from the bottle, and continue reading a story. Eventually replace the
bottle with a comfort item, such as a favorite stuffed toy or
blanket.

Provide other sources of
calcium, such as yogurt or cheese, if your baby is not
drinking at least
16 fl oz (500 mL) of formula
from a cup each day. Your baby needs calcium every day for growth.

Common concerns

I'm pregnant. Should I stop breast-feeding my first child? No, you can continue to breast-feed your
first child while you are pregnant. But talk to your doctor about your
nutritional needs and other issues you should be aware of. For more
information, see the topic
Breast-Feeding .

I want to become pregnant. Should I wean my child? You can continue to
breast-feed, but breast-feeding may make it harder to become pregnant.
For more information, see the topic Breast-Feeding.

When I wean, should I be concerned about my baby's teeth? Be
sure to give your baby adequate nutrition to build healthy teeth. And as you
wean your baby from the breast or the bottle, limit sugary liquids, especially
at bedtime. This can cause dental
cavities. Don't put your baby to bed with a bottle.
And after 12 months of age, stop night breast-feedings. For more information,
see the topic
Teething .

What if I develop pain and tenderness in my breasts while trying to wean?Breast engorgement is less likely to occur if you
gradually wean your baby rather than suddenly stop breast-feeding. Weaning from
the breast is easier when your baby is already taking solid foods and has been
breast-feeding less often. The pain and discomfort from breast engorgement
improve as your breasts stop making milk. You will likely feel better in 1 to
5 days. Home treatment, such as applying cold packs to the breasts, may relieve
some of your symptoms. For more information, see the topic
Breast Engorgement .

Should I start or stop giving supplements to my child? Most doctors suggest
daily
vitamin D supplements for children. Talk with your doctor about how much and what sources of vitamin D are
right for your child. Babies who are breast-fed may also need a fluoride supplement starting at 6 months of age.

Promoting Healthy Growth and Development

It's
important not only for you to give your baby nutritious foods and drinks but
also for you and your baby to interact with each other during mealtimes. These
things help your baby's mind and body grow. Breast milk (with supplements) and formula give babies
all the calories and nutrients they need until they are 6 months old. After
that, babies need other nutrients and energy from solid foods. You can
wean gradually or abruptly in order to get your baby
what he or she needs for growth. When you make choices about weaning, always
think of your baby's emotional needs, age, and readiness as well as your own
needs.

The weaning process

The American Academy of
Pediatrics recommends that babies be breast-fed for at least a year and as long
after a year as mother and child desire.1

If you are not breast-feeding and your baby is younger than 12
months of age, use
iron-fortified
formula . Do not offer your baby cow's
milk.1 The iron in cow's milk is not well-absorbed,
and iron is necessary for healthy development. Also, some babies may be more
likely to react to the
protein in cow's milk .

Most children need whole milk when they are 1 to 2 years of age. But your doctor may recommend 2% milk if your child is overweight or if there is a family history of obesity, high blood pressure, or heart disease.

When you have decided that you and your child are ready
to give up breast- or bottle-feeding, develop a plan for what you will do. Talk
with other family members and get their help.

In general, you can
start
giving your baby solid foods at 4 to 6 months of age.
Feed your baby at the table with the rest of the family. Follow your doctor's
advice on when and what to feed your baby. 1 Usually, the more
solid foods a baby eats, the less breast milk or formula he or she needs, and
the easier it is for your baby to switch from the breast or bottle. Be sure your child gets the recommended
vitamins and minerals for children .

Weaning from breast- or bottle-feeding can be done gradually or abruptly.
Watch for
signs that your baby is ready to wean . To gradually stop breast- or
bottle-feeding while you
offer cup-feeding and/or solid foods, give up the least important feeding
first, which is usually the midday one. Then stop the late afternoon and
morning feedings. Stop the most important feeding (the one that provides the
baby the greatest emotional comfort) last: this is usually the first or last
feeding of the day. Whether you are weaning or not, the last feeding should
gradually be moved up so that by 4 months it is no longer at bedtime and other
soothing rituals can be established. Pay attention to whether your baby is
sucking for comfort or hunger.

Tips for using a cup

Strive to have your baby using a cup instead of a bottle around 1 year of age. And help your child to start using a lidless cup by age 2. To help get your baby learn to use a cup, try these tips:

Show your baby different types of cups and let
him or her choose.

Try to use cups with a spout, two handles, and
a rounded, weighted bottom. If your baby accidentally bumps the cup, it will
stay upright and less liquid will be spilled.

If the cup does not
have a lid and spout, put only about one sip of liquid at a time in the cup, in
case your baby tips the cup over.

Do not be upset if your baby
just wants to play with the cup at first.

And to help prevent injuries from using bottles and cups during unsteady walking, have your child stay seated while drinking.

Gradual weaning

A gradual weaning slowly reduces
the number of breast- or bottle-feedings. One feeding is eliminated every 5 to
7 days, giving the mother and baby time to adjust. Gradual weaning helps
maintain emotional attachment, prevents
breast engorgement for mothers who are breast-feeding, and allows the baby to learn other
ways of eating. Gradual weaning is generally planned to suit both the mother's and child's
needs.

Gradual weaning is best for both you and your baby. It is
recommended for babies unless the mother has a medical condition that does not
allow it.

Abrupt weaning

Abrupt weaning is a sudden end to
breast- or bottle-feeding and can be hard for both the mother and the
child. The breast-feeding mother may experience painful breast engorgement and has an
increased risk for a breast infection (
mastitis). Both the mother and the
child may miss the emotional attachment and closeness of breast- or
bottle-feeding.

Your child may respond to abrupt weaning
by:

Refusing to drink from a cup for a period of
time. Prolonged refusal to drink from a cup can lead to
dehydration and nutritional
deficiencies.

Sucking his or her thumb.

Times you may not want to wean

You may not want to wean your baby:

When a child is learning new skills. Learning new
skills, such as crawling or walking, can be stressful for your child, and the
breast or bottle may provide comfort and security.

When there is stress in the home. A new tooth, an
illness, a new day care center, or the caregiver starting back to work can all
be stressful. Weaning at this time, or during any difficult time, results in
more stress and more difficulty weaning.

During unusually warm weather. During weaning,
babies sometimes refuse any liquid other than breast milk or formula for 24 to 48 hours.
So weaning your baby when it's very hot outdoors can put your baby at risk for
dehydration.

Weaning a toddler

Gradual or abrupt weaning may
work for 1- to 2-year-olds.

A toddler who breast- or bottle-feeds 3 or
more times a day may do better with gradual weaning.

A toddler who
breast- or bottle-feeds 2 times a day or less may do well with abrupt
weaning.

You may find the following suggestions helpful as you
switch to other types of feeding:

Abrupt weaning for toddlers may help you wean a child
who nurses 2 times a day or less.

As your baby learns to feed himself or herself, keep in
mind that your job is to provide a variety of nutritious foods but your baby
will decide how much to eat. This is sometimes called the
division of responsibility .

When to Call a Doctor

Talk to your child's doctor
about
weaning if:

Your baby refuses all solid food and is older
than 6 to 8 months of age.

Your baby has changed from sleeping
through the night to waking up during the night hungry.

Routine Checkups

A
well-baby checkup is a good time to ask questions
about
weaning. During this checkup, your baby's doctor
will:

Compare your baby's current weight, height, and
head size with measurements taken at birth to see if the rate of growth is
normal.

Ask how well your baby is eating and sleeping and whether
any problems have developed.

Other Places To Get Help

Organizations

American Academy of Pediatrics

141 Northwest Point Boulevard

Elk Grove Village, IL 60007-1098

Phone:

(847) 434-4000

Fax:

(847) 434-8000

Web Address:

www.aap.org

The American Academy of Pediatrics (AAP) offers a
variety of educational materials about parenting,
general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other
organizations are also available.

KidsHealth for Parents, Children, and
Teens

Nemours Home Office

10140 Centurion Parkway

Jacksonville, FL 32256

Phone:

(904) 697-4100

Web Address:

www.kidshealth.org

This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.

La Leche League International (LLLI)

957 North Plum Grove Road

Schaumburg, IL 60173

Phone:

1-800-LA-LECHE (1-800-525-3243) (847) 519-7730

Fax:

(847) 969-0460

Web Address:

www.llli.org

La Leche League International (LLLI) offers information and
encouragement—mainly through personal help—to all mothers who want to
breast-feed their babies. It also offers support and information about
breast-feeding babies with various disabilities, such as cleft lip or cleft
palate. Call for information about a chapter in your area.

References

Citations

American Academy of Pediatrics, Section on
Breastfeeding (2005). Breastfeeding and the use of human milk. Pediatrics, 115(2): 496–506.

Other Works Consulted

American Academy of Pediatrics (2009). Age eight months through twelve months. In SP Shelov et al., eds., Caring For Your Baby and Young Child: Birth to Age 5, 5th ed., pp. 249–284. New York: Bantam.

American Academy of Pediatrics (2009). Age one month through three months. In SP Shelov et al., eds., Caring For Your Baby and Young Child: Birth to Age 5, 5th ed., pp. 193–216. New York: Bantam.

American Academy of Pediatrics (2010). Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics, 126(5): 1040–1050. Available online: http://pediatrics.aappublications.org/cgi/content/full/126/5/1040.

Greer FR, et al. (2008). Effects of early nutritional
interventions on the development of atopic disease in infants and children: The
role of maternal dietary restriction, breastfeeding, timing of introduction of
complementary foods, and hydrolyzed formulas. Pediatrics, 121(1): 183–191. Also available online: http://pediatrics.aappublications.org/content/121/1/183.full.

American Academy of Pediatrics, Section on
Breastfeeding (2005). Breastfeeding and the use of human milk. Pediatrics, 115(2): 496–506.

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